Cherry Hemangioma Treatment & Management

Updated: Apr 30, 2018
  • Author: Clarence William Brown, Jr, MD, FAAD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

Medical intervention is not helpful and not indicated in the treatment of the benign vascular proliferations of cherry hemangiomas. Perform biopsy on lesions in which the diagnosis is doubtful. The biopsy procedure may be used as a therapeutic measure to remove traumatized or bleeding lesions.

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Surgical Care

Treatment for cherry hemangioma lesions is recommended only in situations of irritation or hemorrhage or in instances in which the lesions are deemed by the patient to be cosmetically undesirable.

Shave excision allows delicate removal of the lesion by blade and histologic confirmation of the diagnosis. Hemostasis following removal may be obtained by chemical means (aluminum chloride) or by performing electrocautery.

Curettage and electrodesiccation techniques permit reliable elimination of the lesion through tissue destruction. The risk of scarring usually is minimal when the technique is performed by a skilled operator.

Pulsed-dye laser ablation of lesions may be performed for cosmesis. The use of a pulsed dye laser with a green light source allows selective absorption of the laser energy by the hemoglobin contained within the red blood cells and subsequent obliteration of the vascular lumen. [7, 8, 9]

Cryotherapy is a less well-controlled means by which lesions are eliminated through irritation, coagulation, and subsequent destruction.

Sclerotherapy of individual lesions has been shown to have limited therapeutic benefit in treating cherry angiomas. [10]

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Consultations

Dermatologist consultation may be indicated. For multiple cherry hemangiomas that have appeared over a short period, refer the patient for evaluation to exclude an internal malignancy. In several patients, cherry hemangiomas that have erupted over a very short period were associated with an internal malignancy. [1]

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Diet

The occurrence of cherry angiomas has never been demonstrated to have any relationship to diet.

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Activity

The occurrence of cherry angiomas has never been shown to be related to the level of physical activity.

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Prevention

No effective means are available by which the development of the lesions of cherry hemangioma can be prevented.

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Long-Term Monitoring

In general, the benign lesions of cherry hemangioma require no therapy, although lesions that are irritated or bleeding (most commonly secondary to trauma) usually require surgical intervention. Follow-up evaluations usually are arranged approximately 1 month after initial therapy. Occasionally, more than a single treatment is required to eliminate the lesion(s). If the lesions are numerous and present as small macules, consider a bleeding disorder such as thrombocytopenia.

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